Vivid Imagination Station LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

VIVID IMAGINATION STATION LLC

Practice address

216 Justin Ave
Staten Island, NY 10306-3744

Phone

(718) 730-4442

NPI assigned

Jun 28, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Irena BilousNPI 1538510706

Title

Special Education

Phone

(718) 730-4442

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Irena Bilous

  • Specialist
  • Brooklyn, NY
  • NPI 1538510706
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1033954227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 JUSTIN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063744",
            "telephone_number": "718-730-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 JUSTIN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063744",
            "telephone_number": "718-730-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVID IMAGINATION STATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "BILOUS",
        "authorized_official_first_name": "IRENA",
        "authorized_official_title_or_position": "SPECIAL EDUCATION",
        "authorized_official_telephone_number": "718-730-4442"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincent Anthony Vitulli
• Carianne Vivaldi, M.A. CCC-SLP
• Abhirami Vivekanandarajah, M.D.
• Adrienne M. Viviano, P.A.
• Arlene Viviano, RN
• Vivid Minds, LLC
• Vladimir Fedosseev Physical Therapy PC (VF Physical Therapy)
• Nicholas Vlassenko, PT
• Margarita Vodopyanov, LMSW
• Brielle Vodovoz, R.N.

• Early Intervention Provider Agency in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.